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The list of educational opportunities specifically geared towards correctional medicine is woefully short. We correctional specialists need to take advantage of as many of our own conferences as we can.

One excellent resource for several years has been the one day conference put on by the American College of Correctional Physicians (formally known as the Society of Correctional Physicians). Historically, this conference has always been held on the Sunday before the NCCHC National Conference held in October. These ACCP conferences have always been excellent, but only held then.

This year, however, is different. This year, the ACCP is also hosting a spring conference tied to yet another excellent educational opportunity in correctional medicine: the Academic Consortium on Criminal Justice Health. The Academic Consortium conference will be held this year in Atlanta on March 16th and 17th. ACCP’s one day conference will be held immediately afterwards, on March 18th, a Saturday.Continue reading →

As it was last year, Essentials will be held at the Hilton Hotel in Downtown Salt Lake City, Utah.
Conference attendees will have a continental breakfast and full lunch each day of the conference. More important, though, will be the excellent quality of medical education.

Wednesday, February 19, 2014

David Sasser, JD. Dave has specialized in correctional law throughout his career. I have worked with Dave for many years and I can tell you that he is a great speaker; both interesting and funny. Dave’s first talk is entitled “Legal Overview of Case Law in Correctional Medicine.” Don’t let the title intimidate you! Dave says most people who work in corrections do not know all of the safeguards built into the legal system to aid and protect them. After this talk, you will know how to walk among the landmines (so to speak).

The second of Dave’s presentations will be “A Review of Case Law in Correctional Medicine.” This will be a group discussion about actual lawsuits and their outcomes. Each of these cases is unique. Why was the jail sued? How could the lawsuit have been avoided? Was a mistake made medically? Was a mistake made legally? What was the outcome? I find malpractice cases fascinating, myself.
Do you have a lawsuit hanging over you right now? Bring it up! Let’s discuss it!

“Managing Those Surprising Drugs of Abuse in Corrections.” We will talk about gabapentin, amitriptyline, Wellbutrin, and many others. What other medications have you seen diverted and abused in your facility? Let’s talk about it!

“Medications Behind Bars—the Most Common Mistakes.” Observations by a Correctional Pharmacist. Do you have questions for our panel of correctional pharmacists? Formulary? Storage of scheduled drugs? Bring it on!

Thursday, February 20, 2014

Noel Gardner, MD is a forensic psychiatrist who will speak on Wednesday about psychiatric malingering and symptom magnification. His first lecture, “Disease, Distress, Disguise or Deception,” lays the groundwork for understanding the dynamics behind deception.

Dr. Gardner’s second lecture is entitled “Malingering: The Psychodynamics of Medical Manipulation; How to Recognize It, and What to Do About It.” You will be taking copious notes because this is information that will be immediately useful to you in your home facility.

Dr. Scott Eliason will follow Dr. Gardner. Oftentimes, we correctly identify a patient in our facilities as malingering or exaggerating a psychiatric illness, but we cannot simply walk away—this is still our patient. What do we do now? Medication? Counselling? Behavioral Modification? Dr. Eliason will share his experience with these patients in his years of working in prisons and jails.

Brian Mecham, LCSW has been working as a mental health counselor in jails for many years. His assignment is to answer the question of “How to Manage Personality Disorders Without Drugs.”

Finally, Neelie Berlin, who has been a jail medical provider for years in addition to her other job as a dermatologist, will speak on “Dermatology Behind Bars.” Neelie, of course, will have lots of gnarly slides and will make your life simpler with many, many tips on how to deal with the weird rashes that always crop up behind bars. Do you have a rash in your facility that is kicking your butt? Bring a picture and Neelie will help.

Friday, February 21, 2013.

Our Keynote Speaker, Dr. Joseph Bick, will present “Correctional Medicine in a Malaysian Prison—Lessons for American Prisons.” There is a reason that we picked Dr. Bick to be our Keynote Speaker. Well, four reasons, really. One, he is a wonderful and interesting speaker. Second, he is an infectious disease expert, and infectious disease is always a timely topic for jails and prisons. Third, Dr. Bick has a fascinating story to tell. For the past year, Dr. Bick has worked as a correctional physician in a prison in Malaysia. You think you have it bad? You will feel a lot better about your work environment after hearing this talk. Finally, this is an uplifting and motivational talk that will send you back to work with a spring in your step.

Dr. Bick’s second talk is entitled “What’s new in HIV, Hepatitis C and TB.” Hepatitis C is especially timely because of the pressure to use the new, unbelievably expensive, protease inhibitors coming on the market.

Dr. Carl Vance is an endocrinologist who has, for years, been my “Go-To” guy when I have a jail patient with a difficult endocrine problem. He has helped me (and many others) with his timely and practical advice. Carl has distilled many of his practical tips into his lecture: “Endocrine Potpourri.” This lecture receives rave reviews whenever it is given. Carl says that whenever he gives this lecture, he spends another half hour answering questions out in the hall—so please bring your diabetic and endocrine problems. We will allow plenty of time for questions and discussion!

The final speaker of the conference will be me. My experience prior to corrections is as an Emergency Physician, so I am going to talk about “A Simplified Approach to Abdominal Pain and Chest Pain.” The final lecture of the conference will also be mine and is entitled “Interesting Cases in Correctional Medicine.” I am going to pick my weirdest and most interesting cases to present and discuss.

Although seats for this conference are filling up fast, there is still room. Please register!

Your patient is a 29-year old male who presents to the medical clinic stating that he has been having a feeling of a racing heart off-and-on for the last couple of months. It comes and goes, maybe two or three episodes a week. They only last a few minutes. He feels odd when this happens but he does not have to stop his activities. He has noticed no pattern to these; they have happened at work (he is an inmate worker), in the middle of the night and every time in between.

His physical exam is normal including blood pressure of 124/78, regular heart rate of 68 and normal heart sounds.

It will be held February 18-21, 2014 in the Downtown Hilton Hotel in Salt Lake City, Utah.

Last year’s conference was a great success. We had much greater participation than we had anticipated and the comments we received from the conference participants were almost all positive. However, we did get some suggestions for improvements that we are using to make Essentials 2014 even better!

Much like last year’s conference, here is what you can expect:

This is a working conference. Do not expect a lot of free time. Do expect to learn a lot.

This is a conference for Correctional Medicine Professionals. Each and every lecture will specifically pertain to medicine practiced in jails, prisons and juvenile facilities.

Excellent, engaging speakers. We have three requirements of our speakers. First, that they teach up-to-date, useful material. Second, that they are enthusiastic and engaging. Useful information does no good if the presentation is so boring that you slept through it. Finally, they must relate their presentations to correctional medicine. We in correctional medicine must always keep safety, security, and the possibility of symptom magnification for gain in the back of our minds in a way that outside physicians find foreign.

We have made several changes and improvements to the conference format based on the suggestions and critique of last year’s participants:

Fewer speakers speaking on more topics.

More time for questions. Each speaker will devote time to answering questions. Also, each day we will bring all of the speakers together with the conference participants and have a question and answer and discussion session. Expect debates!

Protocols. Each clinical lecture will come with a sample protocol. Whether you call them Policy and Procedures, Standard Operating Guidelines or simply Protocols, writing these suckers is hard work. So besides lecture notes, conference participants will leave with a good number of clinical policies that they can easily adapt to their particular institution.

More vendors. We especially are looking for vendors with new products that can make our lives better.

More “working on a full stomach.” Since this is a working conference, continental breakfast and lunch will be provided most days so we can keep on learning!

2014 Conference Topics.

Infectious diseases. Our Keynote Speaker, Dr. Joseph Bick, is an expert in infectious diseases and a great speaker. He is currently on sabbatical working as a correctional physician at a prison in Malaysia, of all places. Dr. Bick will share those experiences with us in the Keynote Address, and then will address many of the infectious disease conundrums we face in Correctional Medicine.

Dermatology. Every correctional physician needs a dermatology consultant to send grody rash pictures to. Mine is Neelie Berlin, enthusiastic rash expert who also happens to also be a wonderfully entertaining speaker.

Medico-legal matters. I personally always enjoy legal discussions and case analysis. Hearing about bad-outcome legal cases is like driving by a bad wreck on the freeway—you just can’t look away.

Symptom magnification and malingering. Does any medical profession have to deal as much with this issue as we in corrections do, day after day after day? Answer: Ah, no. Essentials will have presentations about detecting deception, properly documenting these encounters in a medico-legal friendly way and dealing effectively with these inmates without confrontation. Forensic Psychiatrist Dr. Noel Gardner will discuss symptom magnification and malingering in the psychiatric realm. Wonderfully entertaining as well as essential information.

Essentials of Correctional Medicine was held last week in Salt Lake City, Utah and included some great talks. Today’s post is a list of Pearls I gleaned from the conference speakers.

The definition of a “Pearl” is a bit of pithy and insightful information that can be communicated in one or two sentences. Hopefully, it is also something that you have not thought of yet and will change your practice for the better.

I ran into several Pearls at the Essentials conference. Here is a sampling (in no particular order): Continue reading →

I just returned from this year’s NCCHC convention. It was excellent, as always. A very important announcement was made at the Society of Correctional Physicians’ meeting on Sunday that deserves more publicity than it is getting.

One of the challenges I see for those of us who practice Correctional Medicine is that there are too few educational opportunities specifically designed for us.

There are a few: NCCHC has great conferences. The Society of Correctional Physicians puts on wonderful conferences. In fact, perhaps the overall best correctional medicine conference I personally have attended was an SCP conference. The next SCP conference is October 16th, information here.

Mike Puerini, coincidentally the President of the Society of Correctional Physicians, organizes a conference twice a year for the Oregon Department of Corrections which anyone can attend. His next conference is September 12, 13 in Salem, Oregon. Interested? Contact him directly: mike.t.puerini@doc.state.or.us .

The Academic Consortium on Criminal Justice Health organizes a yearly conference in the spring, geared towards academic issues and research. Information can be found here.

But that is not enough. Even with these conferences, we Correctional Medical Specialists been forced to obtain much of our ongoing medical education and updates from other specialties. I tend to go to emergency medicine events, since that used to be my specialty. But now, my specialty is Correctional Medicine. And Correctional Medicine is a specialty in its own right. We need more conferences designed for us, Correctional Medical Specialists!

So to this short list, add Essentials of Correctional Medicine, scheduled this year, November 7,8, and 9th in Salt Lake City. The Essentials of Correctional Medicine website is found here.

Essentials of Correctional Medicine is an intensive 3-day, no-fluff course dealing exclusively with clinical problems in correctional medicine. The course is designed to give Correctional Specialists the essential information they need to care for patients in jails, prisons and juvenile facilities.

I have helped organize this conference and I am quite excited about the faculty we have been able to put together! I myself am speaking and I just well may be the weakest link! I don’t anticipate any “snoozer” classes. We plan on putting this conference on every year, each year emphasizing different clinical themes. Our goal is to have engaging, passionate and knowledgable speakers, so if you know of someone who is a great speaker on correctional medicine topics, please let us know so we can sign them up for future conferences!

Target Audience

Essentials of Correctional Medicine is designed for medical professionals who work in jails, prisons and juvenile detention facilities. Correctional Physicians, PAs, Nurse Practitioners and Nurses will all find the material engaging and useful.

Venue

Essentials of Correctional Medicine will be held in the beautiful Hilton Salt Lake City Center in downtown Salt Lake.

Speakers

Marc Stern, MD, MPH. Amazingly prolific consultant in Correctional Health Care, Assistant Professor, School of Public Health, University of Washington.

Deana Johnson, JD. General Counsel MHM Correctional Services and one of the few full-time practitioners of correctional law. Outstanding speaker.

Katie Clark, RD, MPH, CDE. Assistant Clinical Professor of Nutrition at the University of California, San Francisco (UCSF), San Francisco. Great speaker, blogger (http://fiberisthefuture.com/) and a dietician actually interested in operations in correctional facilities.

Jeffrey Keller MD FACEP. Medical director of the Ada Co. Jail in Boise, Idaho along with 12 other jails and juvenile facilities in Idaho. Frequent speaker and writer on correctional health care.

About

Jeffrey E. Keller is a Board Certified Emergency Physician with 25 years of emergency medicine practice experience before moving full time into his “true calling” of Correctional Medicine. He is the Medical Director of Badger Medical, which provides medical services to several jails and juvenile facilities in Idaho. Dr. Keller is available for consultation on any aspect of Correctional Medicine, including legal cases, program development, and system analysis.

Expert Consultation in Correctional Medicine

Dr. Keller is available for consultation on any aspect of Correctional Medicine, including legal cases, program development, and system analysis. Dr. Keller has wide experience in both jail and prison systems and in both clinical practice and administration. Read more

Join the American College of Correctional Physicians!

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